No abstract

Several of the 24 deaths could potentially have been avoided by more extended use of airway algorithm, thorough preoperative evaluation, training, education, and use of protocols for diagnosis and treatment.

No abstract

Multi-component lipid emulsions, rather than soy-oil emulsions, prevent cholestasis by an unknown mechanism. Here, we quantified liver function, bile acid pools, and gut microbial and metabolite profiles in premature parenterally fed pigs given a soy-oil lipid emulsion, Intralipid (IL), a multi component lipid emulsion, SMOFlipid (SMOF), a novel emulsion with a modified fatty-acid composition [experimental emulsion (EXP)], or a control enteral diet (ENT) for 22 days. We assayed serum cholestasis markers, measured total bile acid levels in plasma, liver, and gut contents, and analyzed colonic bacterial 16S rRNA gene sequences and metabolomic profiles. Serum cholestasis markers (i.e., bilirubin, bile acids, and γ-glutamyl transferase) were highest in IL-fed pigs and normalized in those given SMOF, EXP, or ENT. Gut bile acid pools were lowest in the IL treatment and were increased in the SMOF and EXP treatments and comparable to ENT. Multiple bile acids, especially their conjugated forms, were higher in the colon contents of SMOF and EXP than in IL pigs. The colonic microbial communities of SMOF and EXP pigs had lower relative abundance of several gram-positive anaerobes, including Clostridrium XIVa, and higher abundance of Enterobacteriaceae than those of IL and ENT pigs. Differences in lipid and microbial-derived compounds were also observed in colon metabolite profiles. These results indicate that multi-component lipid emulsions prevent cholestasis and restore enterohepatic bile flow in association with gut microbial and metabolomic changes. We conclude that sustained bile flow induced by multi-component lipid emulsions likely exerts a dominant effect in reducing bile acid-sensitive gram-positive bacteria.

This paper builds on a key finding of a 5-year Danish research project concerning children in the 7 to 15 age group: children's principal use of computers and the internet takes place in their spare time, and it is during their spare time that the majority of children really learn how to use interactive media. The project shows that in children's spare-time use of ICT they employ informal forms of learning based to a large extent on their social interaction both in physical and virtual spaces. These informal learning forms can be identified as learning hierarchies, learning communities and learning networks; they are important contributions to the school of the knowledge society. The ICT in New Learning Environments project based on anthropologically inspired methods and social learning theories shows that students bring their informal forms of learning into the school context. This happens particularly when the school has undergone physical alterations and when its organisation of learning and teaching are also restructured, with project-based learning becoming an important part of the school work and with the media available in the learning environment. Using organisation theory, the school working with ICT and projectbased learning is shown to simultaneously constitute a mixed mode between the school of the industrial and the knowledge society. The research shows that it is possible to tip the balance in the direction of the school of the knowledge society, and thus of the future, by comprehensively using ICT and project work in the day-to-day activities of the school, alongside and integrated with the traditional forms of learning, and not least by employing the informal learning processes children develop outside school. For teachers this will mean an extension of their function: no longer merely communicators of knowledge, they will have to become knowledge managers and overall leaders of projects, and this entails much more dialogue with the pupils.